The Distinguished Dozen: Twelve Books That Shaped the Face of Family Medicine

Of the many books that have been written on or about Family Medicine, which ones are the most influential in developing the specialty today?

To help answer this question, we went to a distinguished panel of experts that included leaders, educators, authors and practicing family physicians from across the specialty.

It was no easy task. After considering countless books, the panel chose twelve works they felt were the most significant in contributing to shaping the current face of our specialty. The result is this exhibit: "The Distinguished Dozen."

These twelve books offer an extraordinary glimpse into the history, development and culture of the specialty. Published from the years 1966 to 2001, they range from scholarly studies on theory, practice and application to highly personalized memoirs and essays detailing the human side of being a family physician. Some were written by physicians, some by laymen; some are erudite and clinical in tone, while others are highly charged with raw emotion. Yet despite their differences, they all have one thing in common: they have unquestionably made their mark on the practice of Family Medicine in America today.

Ferment in Medicine by Richard M. Magraw, MD (1966)

"Who would have thought that a book written by a psychiatrist/internist, scarcely mentioning 'family medicine,' would be perceived as one of the books most influential in the development of our specialty?... We all read this book in the 1960s. It articulated the need for family physicians more clearly than we had previously heard. Its impact was enhanced by publication at a time when the public cried for a replacement for the disappearing general practitioner. Its insights helped form a consensus that American medicine needed strong primary physicians.

"...The beauty of re-reading Ferment in Medicine is that issues Dr. Magraw raised are as real today as they were 44 years ago. They will be equally real 44 years from now."

--Jack M. Colwill, MD, Columbia, Missouri

THEN (1966): A Professor in the Department of Internal Medicine & Psychiatry at the University of Minnesota, and Director of the Comprehensive Clinic Program at the University of Minnesota Medical School.

During his career, Dr. Magraw served as Professor of Psychiatry at the University of Minnesota and Chief of the Psychiatry Service at the Minneapolis VA Medical Center. While at the Minneapolis VAMC, Dr. Magraw also helped to establish the Cognitive Neuroimaging Unit within the Psychiatry Service.

[Richard M. Magraw, MD]
Richard M. Magraw, MD

Textbook of Family Practice by Robert E. Rakel, MD (1973)

"As the specialty of family medicine was breaking dawn over the horizon in 1970, Bob Rakel... set out on a journey to establish 'A Textbook of Family Practice.' This journey has now traveled into its 8th Edition and has evolved to become known as Rakel's 'Textbook of Family Medicine.' The first edition in 1973 is full of groundbreaking pioneers who helped to establish a beachhead in the development of the education and research presence on family medicine throughout the country...

"This textbook incorporated chapters which, maybe for the first time, addressed the family, community medicine and human behavior, as well as the traditional medical topics. It showed the reader the depth and breadth of family medicine. For example, Hiram Curry's thirty-page chapter on neurology is probably one of the best written and most comprehensive sections on this topic to date. Bob Rakel's ability to assemble the national expertise such as this has been outstanding, then and over the years."

--Michael L. Coates, MD, MS, Winston-Salem, North Carolina

THEN (1973): Professor and Head of the Department of Family Practice at the University of Iowa Hospitals and Clinics in Iowa City, Iowa. From 1973 to 1975, Dr. Rakel served as the first editor of STFM's Selected References in Family Medicine. (Later, from 1986-1993, Dr. Rakel also served as host of the program "Family Practice Update" on Lifetime Medical Television.) 

During his career, Dr. Rakel served as Professor of Family and Community Medicine at Baylor College of Medicine in Houston, Texas. He is also known in Family Medicine as a prolific writer and editor. 

[Robert E. Rakel, MD]
Robert E. Rakel, MD

Family Medicine: Principles and Practice by Robert B. Taylor, MD (Six Editions: 1978-2003)

"Robert Taylor is one of the great scribes of family medicine... Like so many of the 'founding fathers' of the discipline, he decided to become a teacher and leader. Fortunately for all of us, he is a superb writer and he has left a legacy of books and journal articles... The greatest value of Taylor's Family Medicine is not in the solid clinical chapters that make up the bulk of the book, but the insightful chapters in Part 1 of each edition, The Principles of Family Medicine... These early chapters are a great historical reference for family medicine's development during this important early period... Always the observer and historian, Bob wanted to make sure that the exciting history of his beloved discipline was captured for posterity. For this we are grateful and his textbook in each edition deserves a place among the books that shaped the field."

  --Joseph E. Scherger, MD, MPH, San Diego, California

THEN (1978): Associate Professor in the Department of Family and Community Medicine at the Bowman Gray School of Medicine in Wake Forest University, Winston-Salem, North Carolina. (Prior to this, from 1964 to 1978, he served as an Attending Staff Physician at the Kingston City Hospital in Kingston, New York.)

Dr. Taylor is well known in Family Medicine as a prolific writer, editor and presenter, and was named Professor Emeritus of Family Medicine at the Oregon Health & Sciences University, Portland, Oregon.

[Robert B. Taylor, MD]
Robert B. Taylor, MD

Archives of Family Practice by John P. Geyman, MD (1980-1982)

"If Stephens was the philosopher, Geyman was the scribe of the new specialty of family medicine. This collection of early writings has unique articles from the 1960s as the specialty came into focus. The early work of Nicholas Pisacano [first Executive Director and Secretary of the American Board of Family Practice, now ABFM], captured here, is classic information about the birth of family medicine... This books tells what made family medicine. It is a book about the gestation and birth of the specialty... Being able to read the writings from the mid-1960s meant a lot to my understanding of the specialty and its legacy."

  --Joseph E. Scherger, MD, MPH, San Diego, California

THEN (1980-1982): Professor and Chairman of the Department of Family Medicine at the University of Washington in Spokane. From 1973 to 1990, Dr. Geyman served as founding editor of The Journal of Family Practice.

During his career, Dr. Geyman served as Professor Emeritus of Family Medicine at the University of Washington in Seattle and was elected to the Institute of Medicine (IOM) in 1985. Dr. Geyman also served as editor of The Journal of the American Board of Family Practice from 1990 to 2003. He continues to author books about Family Medicine and the U.S. health care system, and is an occasional blogger for The Huffington Post.

[John P. Geyman, MD]
John P. Geyman, MD

An Introduction to Family Medicine by Ian R. McWhinney, OC, MD, FRCGP, FCFP, FRCP (1981)

"With his landmark text, Introduction to Family Medicine (1981), expanded into the Textbook of Family Medicine (1989), now in its third edition (2009), Professor Ian McWhinney laid the intellectual foundations of family medicine as a distinct discipline... The history of the text parallels the history of the discipline. Stone has been laid upon stone, fitted by many builders with increasingly exact standards. The footprint has stayed remarkably true to form and the structural integrity of the whole relies upon the early foundation.

"The McWhinney book was always more than a reference text for a day in the office.  It was-- and still is-- a compass for a career in the specialty. It still serves as a blueprint for the house of family medicine, even as we remodel it into the patient centered medical home of the future."

  --William R. Phillips, MD, MPH, Seattle, Washington

Then (1981): Professor in the Department of Family Medicine at the University of Western Ontario in London, Ontario, Canada. Before his death in 2012, he served as Professor Emeritus of Family Medicine in the Centre for Studies in Family Medicine at the University of Western Ontario, London, Ontario; he was elected to the Institute of Medicine (IOM) in 1988.

During his career, Dr. McWhinney was named Professor Emeritus of Family Medicine in the Centre for Studies in Family Medicine at the University Western Ontario, London, Ontario. He was elected to the Institute of Medicine (IOM) in 1988.

Update (2012): Dr. McWhinney died on September 28, 2012, at the age of 85.

[Ian R. McWhinney, OC, MD, FRCGP, FCFP, FRCP]
Ian R. McWhinney, OC, MD, FRCGP, FCFP, FRCP

The Intellectual Basis of Family Practice by G. Gayle Stephens, MD (1982)

"In just 15 years (1966 to 1981), family practice, in the words of Gayle Stephens, evolved from a highly debatable abstraction to the third largest graduate medical education enterprise in the United States... The history of family practice has been chronicled by many writers, notably John Geyman and Robert Taylor, but the clearest description of the theoretical basis of the new specialty belongs to Gayle Stephens. Always a humble man from Kansas who counted his blessings as a witness to history, Gayle became the towering voice for family practice as a reform specialty within medicine."

  --Joseph E. Scherger, MD, MPH, San Diego, California

Then (1982): Professor and Chairman of the Department of Family Practice at the University of Alabama at Birmingham; prior to this, Dr. Stephens had been the founding Director of the Family Practice Residency Program at Wesley Medical Center in Wichita, Kansas, and had also served as President of STFM from 1973 to 1975.

During his career, Dr. Stephens was named Professor Emeritus at the University of Alabama at Birmingham. In 1996, he received the AAFP's John G. Walsh Award for outstanding contributions to the specialty, and was elected to the Institute of Medicine (IOM) in 2006.

Update (2014): Dr. Stephens died on February 20, 2014, at the age of 85.

[G. Gayle Stephens, MD]
G. Gayle Stephens, MD

The Doctor Stories by William Carlos Williams, MD (1984)

"Some liken reading Williams's essays to watching a film noir about the dark underside of a physician's life... with simple, concrete, everyday words, Williams brings the reader as close to unclothed, fully exposed events he witnessed as is possible. No euphemisms, no convoluted sentences full of abstract ideas, no masking of 'unsuitable' or politically correct thoughts or emotions... The stories are touchstones forcing readers both to reflect on how they might respond to similar circumstances and to recognize the flaws all physicians share by virtue of being human. Medical students still in their pre-cynical years may at first find these stories off-putting or threatening, but they invariably become excited about the difficult issues contained within. These stories of tough love rather than bland, idealized empathy give them license to discuss the realities of their training to become not saints but physicians."

  --Richard Sobel, MD, Beer-Sheeva, Israel

THEN: Born in 1883, Williams graduated from the University of Pennsylvania Medical School in 1906 and practiced as both a pediatrician and a general practitioner from 1910 until 1951. Though best known as a poet, he also wrote short stories, plays, novels, critical essays and an autobiography. Following his death in 1963, he was posthumously awarded the Pulitzer Prize. (The 1984 book The Doctor Stories, a collection from Williams' earlier works, was compiled by Robert Coles, MD, who shared the stories with his students at Harvard Medical School. In addition, the book contains a memoir of Williams written by his son, Dr. William Eric Williams, entitled "My Father, the Doctor.")

[William Carlos Williams, MD]
William Carlos Williams, MD

Heirs of General Practice by John McPhee (1984)

"It gave me great joy to revisit Pulitzer Prize winner John McPhee's short book Heirs of General Practice. First appearing as an essay in the New Yorker, July 23, 1984, published as a stand-alone book later that year, and then gathered together as part of a collection in 1985, much of McPhee's account of rural family medicine rings true today-- the discussions of turf and referrals, long hours and hospital meals, patients who follow our advice, and some who don't. I have the sense of peering into a time capsule-- the specialty of family medicine was younger, and arguably more optimistic; I was finishing residency and eager to enter my own rural family practice; and, the force of DRGs, for profit medicine and merger-mania was just beginning to be felt. To read this essay is like glancing through a box of old photographs-- you recognize yourself, but can hardly believe the time that has passed."

  --Jeff Susman, MD, Cincinnati, Ohio

THEN (1984): Born in Princton, New Jersey in 1931 and educated at Princeton University and Cambridge University, McPhee began writing for The New Yorker weekly magazine in 1965.

Dr. McPhee is still associated with The New Yorker. Widely considered as one of the pioneers of narrative nonfiction in literary journalism, he is also famed for his work as a writing instructor at Princeton. In 1999, he was awarded the Pulitzer Prize for his work Annals of the Former World.

[John McPhee]
John McPhee

The Physician as Teacher by Neal A. Whitman, EdD, and Thomas L. Schwenk, MD (1987)

"Academic physicians are rarely hired for their teaching skills, and many of us who are teaching full-time have had no training to prepare us for this responsibility.  This book can remedy this deficiency. The book also has great value for practicing physicians. For those who teach part-time, it could help them be more successful in their roles as teachers and students. For others, because it uses examples of patients as learners, it might help improve skills as teachers of patients and improve medical outcomes... I am currently in my 40th year as a full-time teacher of family medicine. Retrospectively, I wish that I could have had some training in teaching methods. I might have been more effective as an educator. Regardless, this book will help me now. It will be my bible for teaching residents, medical students and patients. Using it will prove that you can teach old dogs new tricks."

  --Roy J. Gerard, MD, East Lansing, Michigan

Dr. Whitman

THEN (1987): Associate professor and director of educational development, Department of Family and Preventive Medicine at the University of Utah School of Medicine at Salt Lake City.

During his career, Dr. Whitman has authored more than 100 publications and is known as a "teacher's teacher." He has worked with medical doctors since 1971. He retired from academic medicine in 2008 and was named Professor Emeritus by the University of Utah School of Medicine. He remains active in the publishing field and now focuses on Western-form and haiku poems.

Dr. Schwenk: 

THEN (1987): Associate Professor in the Department of Family Practice and Assistant Professor, Department of Postgraduate Medicine and Health Professions Education at University of Michigan Medical School in Ann Arbor. 

During his career, Dr. Schwenk served as Professor of Family Medicine and Chair of the Department of Family Medicine at the University of Michigan. He was elected to the Institute of Medicine in 2002. He also served as the dean of the University of Nevada School of Medicine, and vice president of the University of Nevada-Reno Division of Health Sciences.

[Neal A. Whitman, EdD]
Neal A. Whitman, EdD
[Thomas L. Schwenk, MD]
Thomas L. Schwenk, MD

Textbook of Family Medicine by Ian R. McWhinney, OC, MD, FRCGP, FCFP, FRCP (1989)

"With his landmark text, Introduction to Family Medicine (1981), expanded into the Textbook of Family Medicine (1989), now in its third edition (2009), Professor Ian McWhinney laid the intellectual foundations of family medicine as a distinct discipline... The history of the text parallels the history of the discipline. Stone has been laid upon stone, fitted by many builders with increasingly exacting standards. The footprint has stayed remarkably true to form and the structural integrity of the whole relies upon that early foundation.

"The McWhinney book was always more than a reference text for a day in the office.  It was-- and still is-- a compass for a career in the specialty. It still serves as a blueprint for the house of family medicine, even as we remodel it into the patient centered medical home of the future."

  --William R. Phillips, MD, MPH, Seattle, Washington

Then (1981): Professor in the Department of Family Medicine at the University of Western Ontario in London, Ontario, Canada. Before his death in 2012, he served as Professor Emeritus of Family Medicine in the Centre for Studies in Family Medicine at the University of Western Ontario, London, Ontario; he was elected to the Institute of Medicine (IOM) in 1988.

Update (2012): Dr. McWhinney died on September 28, 2012, at the age of 85.

[Ian R. McWhinney, OC, MD, FRCGP, FCFP, FRCP]
Ian R. McWhinney, OC, MD, FRCGP, FCFP, FRCP

A Measure of My Days: The Journal of a Country Doctor by David Loxterkamp, MD (1997)

"David Loxterkamp has been a rare voice in medicine, more particularly in family medicine, as an observer of life... which includes the office and hospital but is not limited to those venues. His place, and ours as well, is imbedded in community. This book ranks among the great works of writers who describe and reflect on their lives in open, frank and compelling ways. What he discovers through those reflections informs us of the searching, struggling, joyous lives that we can all live if we keep our eyes open, our senses sharp, and our minds working, no matter how the specifics of practice change. David is the doctor who is always thinking about the whys of his life and by writing about what he discovers, will move us to do the same. A Measure of My Days can be read by all family doctors early in their practice careers as a guidebook to what, if we are lucky, lays ahead."

  --John J. Frey III, MD, Madison, Wisconsin

THEN (1997): A family physician living and practicing in Belfast, Maine.

During his career, Dr. Loxterkamp has lived and practiced in Belfast, where he has been for more than 20 years. A prolific author and teacher, he has contributed to a variety of medical journals, including The British Medical Journal, The Journal of the American Medical Association, The New England Journal of Medicine and others.

[David Loxtercamp, MD]
David Loxterkamp, MD

Keystone III: The Role of Family Practice in a Changing Health Care Environment: A Dialogue (2001)

"I first read Keystone III in 2002, when I was working at the National Institute of Program Directors Development on my fellowship project on the history of Family Medicine... As I read the proceedings, I was impressed by the candid discussions captured... the honest self-evaluation, the in-depth and at times harsh analysis of the history, the transparency of the discussions and the respect shown for opposing views... In this profound analysis of our specialty, there is also a deep analysis of the social and economic forces that shaped that 30 year journey... As I re-read Keystone III now in the midst of the intense debate on health care reform, I find once again tremendous pride, inspiration and hope for our specialty, [and] an appreciation for the struggles and the triumphs and challenges we still face as a specialty."

  --Cecilia Gutierrez, MD, San Diego, California

THEN (2001): The Keystone III conference was held in October 2000 in Colorado Springs, Colorado. This event followed two earlier Keystone conferences held in 1984 and 1988. Considered a "family practice think tank," the objective of Keystone III was to discuss the status of family practice after thirty years of development, while also seeking to facilitate the free exchange of ideas between three generations of family doctors: the "founding" generation, the "transition" generation, and the new, "emerging" generation.

Outcomes of Keystone III were eventually incorporated into the Future of Family Medicine (FFM) Project, launched in 2002.

[Keystone III Group Members]
Keystone III

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